The cost of the morning after pill has discouraged many women from using the drug. Boots has been criticized time and again for not making any effort toward lowering the cost of its emergency contraception pill though campaigners have been constantly protesting to lower the cost of the pill by half. This lead us to wonder about several aspects of the pill, and we began researching to find out the following:
- How much does the morning after pill cost in different countries?
- Why is the cost of EC pills considerably higher in some countries like the UK and the US?
- Does the cost of morning after pills have anything to do with the administration trying to control the reproductive health of women?
We will be sharing our findings with you today. But before that, let us learn a little about morning after pills.
Suggested read: Plan B: What Is Emergency Contraception? How Does The Morning After Pill Work?
What is a morning after pill and how does it work?
Image source: Google copyright-free image, under Creative Commons License
Unprotected sex can be scary for a number of reasons, and the simplest way of avoiding those reasons is by using primary contraception, aka, condoms, while having sex. But if you didn’t or the condom broke (yikes!), then instead of freaking out, the first thing you need to do is turn towards emergency contraception or morning after pills.
The morning after pill contains one of the two constituents: Levonorgestrel (E.g. Plan B One-Step) or Ulipristal Acetate (E.g. Ella). So, to make things simpler, we can say there are mainly 2 types of morning after pills, namely the Plan B and Ella. Plan B is more common than Ella, though Ella is more effective than Plan B. However, Ella effectiveness depends a lot on the weight of the person taking the pills. For overweight women, Ella might not work as effectively as is expected from it.
While Ella cannot be bought without a prescription, Plan B is available in any drugstore, without a doctor’s prescription or note.
How effective is a morning after pill?
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Usually, a progestin-only morning pill such as Plan B One-Step or Take Action or even the Next Choice One Dose is very effective in comparison to other contraceptive pills. More effective than these pills are antiprogestin pills. One of the most popular of these is ella.
The treatment provided by the aforementioned progestin-only morning pills have a record of 7 of 8 unwanted pregnancies being prevented. Thus, one can say that there is an 88 per cent effectiveness of these morning after pills to prevent unwelcome pregnancies.
If one takes these progestin-only day after pills within the first 24 hours after the sexual act, the risk of conception is lowered up to 95 per cent.
According to scientific studies, ella remains effective even when taken 5 days or 120 hours after sex.
The other factor on which the effectiveness of the morning pill depends, a very important factor, is where the individual woman stands in her own menstrual cycle when she takes the pill.
Your position in the menstrual cycle determines how effective the morning after pill will be in averting the unwanted pregnancy. If you are about to ovulate, your risk of getting pregnant is higher than in other cases. Also, if you are close to ovulation, you cannot afford to wait 5 days to take the ella pill and expect it to work as efficiently as in the case of a woman who is not ovulating any time soon.
Suggested read: Side Effects Of The Morning After Pills That No One Tells You About
How much does the morning after pill cost?
Image source: Google copyright-free image, under Creative Commons License
United States
In U.S.A., emergency contraceptive pills that contain progestin are available on the shelf. Women are not required to provide an age proof of any sort. You can find morning after pills like Plan B One-Step or Next Choice One Dose in almost all pharmacies. However, the regulations around EC pills have changed repeatedly in the U.S. which makes it confusing.
How much does the morning after pill cost in the US. Let’s find out:
- The EC pills with progestin, such as Plan B One-Step and others like Take Action and My Way, are available in drug stores, and there are no restrictions on their sale. You need not show an ID proof to avail the dry. The Plan B One-Step costs around 50 dollars, and the others cost about 40 dollars.
- To use insurance to purchase morning after pills, you need to contact the pharmacy and seek assistance from them.
- A site called afterpill.com provides generic forms of Plan B One-Step for only 20 dollars. They might charge you about 5 dollars more for shipping. But since expedited shipping isn’t offered, you cannot use depend on this mode of purchase in case of an emergency. Instead, what you can do is buy these pills from the site to stock up your arsenal for future use.
- Ella pills which are more effective, are sold by prescription only, though there is no restriction of age. It will cost you around 70 dollars.
The United Kingdom
As of November 2016, women in England are paying almost five times (yes, you read that right) more for emergency contraceptive pills than women in other European countries.
Experts and the ordinary people have expressed outrage at how the government is making no effort to make the drug available off the shelf and to reduce the prices of these drugs.
In the UK, unlike the US, France, and Scandinavian countries, the morning after pill is not available to women with consultation. It is necessary for women to undergo a consultation, which in turn, makes it necessary for them to discuss their sex lives with a doctor or a primary health care provider every time they decide to have unprotected sex. Apart from how ridiculous it is, this process of consultation also lowers the effectiveness of the pill, since it is time-sensitive.
The high cost of morning after pills in the UK, and the difficulty to avail the drugs, has led to a framework that is “insulting, expensive, and does not meet women’s needs”, according to what Anne Furedi of the British Pregnancy Advisory Service told The Independent.
Ali, 33, from London writes,
“When I was a student living off £50 a week, £20 for the morning-after pill was a lot.
It is too expensive for some people. That someone is making profit from it undermines the idea of making it available to all. When I was a student living off £50 a week, £20 for the morning-after pill was a lot. In sixth form, the local GUM clinic was only open two days a week, so waiting to go there was not an option.
Since moving to London, a GP appointment is often not available for three weeks so that’s not an option either. Taking a day out of work or education to sit in a walk-in clinic reception, with other people who need more urgent help, is a waste of everyone’s time and effort.
The impact is that the morning-after pill isn’t actually an option for some women. If it’s not an option and a woman gets pregnant then they will rely on more invasive procedures and difficult decisions. Not all men think to offer a contribution towards the morning-after pill when they are as responsible or just as unlucky as the woman involved.”
According to the research, morning after pills cost as less as £5.40 in France and about £12.50 in Germany. In the UK, however, a woman pays about £28 on an average. In Ireland, the cost is higher.
In the UK, approximately 61 per cent of the female populace uses has used EC pills at some point. According to a report on The Times, of the 6 million pills taken by women in the UK every year, nearly half of them are purchased, with the cost as well as the embarrassment associated with availing this drug. The rest 39 per cent is available for free at NHS walk-in centers and Accident & Emergency Departments.
According to the ECEC, the behind-counter policy in the UK, “significantly affects women’s access to this method”, and many “felt uncomfortable or judged when obtaining it.”
The availability and the affordability of the drug, however, is not the same thing. For example, in the US, as we just saw, the drugs are easily available, but the costs are exorbitant. To make morning after pills available for women who actually need it, it is necessary that the cost of the pills is lowered and brought to an affordable level in both the countries.
Analyzing why the pills are so costly in these countries, Elizabeth Gay, a program director at the Reproductive Health Technologies Project, which is a nonprofit working to advance reproductive freedom, told Bustle,
“I think that’s something women’s health advocates need to address in the future … The cheapest generic, AfterPill, an emergency contraceptive only available online, is only $20, which is probably an indication that the product doesn’t need to be $50.”
India
In India, which has the second largest population in the world, and is giving close competition to China for the number one position, the emergency contraceptive pill by Cipla, is available over the counter without the need of a prescription and costs about 75 rupees on an average. While this is true on paper, the reality is something else.
Vaisnavi Sundar, a resident of Chennai, a city in the south of India, writes on World Pulse,
“I live in Chennai—a city known as India’s health capital and considered quite progressive. I assumed then that women here were able to find the emergency contraceptive pills (ECPs) they needed. When I heard occasional complaints to the contrary, I reasoned they were about rare cases of low supply. But I was wrong.
When I set out to look for ECPs myself, I walked into one medical shop after another and was told every time that they were out of stock. I went to prominent hospitals, 24/7 medical stores, and even solicited the help of a male friend to buy them for me, but found nothing. What I did discover was that an over-the-counter drug, legally available in India without prescription, was not available in its health capital.”
According to Vaishnavi’s research, there has been an unofficial ban on the sale of morning after pills in the state of Tamil Nadu for the last decade. Calling the ban illogical, Vaishnavi writes,
“Though ECPs have been legally available over the counter in India since 2005, in 2006 the Tamil Nadu Directorate of Drug Control (DDC) pulled them off pharmacy shelves in response to protests by patriarchal fringe groups with moral objections to the pills. These groups opposed the product advertisements that implied young women had free, unprotected sex.”
Selvaraju, who was director of the Tamil Nadu DDC at the time, said,
“We are not against women’s rights, but this is a moral concern. The advertising of this drug will mean that women will think, ‘I can do anything and there is an easy way not to get pregnant’. We can’t allow such an attitude to grow.”
In India, contraception choices by women, is generally looked down upon. The deep rooted patriarchy that glorifies motherhood and treats infertility as a curse, looks at contraception as an immoral act. In such state of affairs, women who are not educated and are poor, make uninformed decisions about their reproduction practices and reproductive health.
A woman who asserts her sexual freedom is quickly branded as a woman of “loose character”. To bust these myths around emergency contraception and start a conversation around the topic, Sundar held protests and sought the support of grassroots campaigning organization, “Jhatkaa”, to run an online petition that received about 3K signatures that supported the access to ECPs in Tamil Nadu.
Suggested read: How Effective Is A Morning After Pill? Let’s Find Out
She writes,
“In response, the DDC director submitted a proposal to the Drug Consultative Committee to include Levonorgestrel, commonly referred to as the morning-after pill, on the list of drugs that can be sold over the counter without a prescription.
This proposal will be considered not only in Tamil Nadu but across India. The DDC also intends to increase the availability and accessibility of the medicine in remote areas throughout India and keep ECPs affordable.
Considering how many women in India go through unnecessary, painful (and often unaffordable) abortions, get pregnant against their will, and worse, are forced to keep a child conceived from rape, this is enormous news.
This step, after ten years of an unofficial ban on ECPs, is especially significant in a country where ideological morality holds high ground, often sidestepping the autonomy women ought to have over their bodies.”
Featured image source: Google copyright-free image, under Creative Commons License
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